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Home My WebLink About4298-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificate Of Occupancy No. Z. 3t~21 ..... Date ........... October.. 29. -., 19.69. THIS CERTIFIES that the building located at ]¥S']lorth' I~ne .......... Street Map NOGard;. B~r' E~?~°ck No. se~ 'III' .Lot No. 1~" 'E'o' .14ar~o~- · ~;,][~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~i&~" ....20'" 19. t~9 pursuant to which Building Permit No.. b~a.9/~Z,.. dated ........... }i~r .... ~>0", 19 {~9., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. 'Private' 'one' I'amlly 'dweT1Xng ..................................... The certificate is issued to . George .L b. Eoch ....... 0~ner ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · ~el~t... FOKM NO. ~ TO~N OF $OUTHOLD BUILDIMG DEP~RTM~NT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. ~295 Z ~o ........................ ~, ......... ,~, .......... , Permission is hereby granted to: ........... b~se..ir,~lt ......................................... ........... ~....ammm~..jt ........................... ........... ~le~f~....J~+ .................................. to ......... ~L ~.. ~11~.. f~ll,~...~3~ ........................................................................... at premises located at ............. ~J~I~...J~J.....GR~II~.Ii..~..]J~$..J.,J~ ............................. .... ~.....=.....~5.....Jat~a.l~ja...~at....~a~ .......... I~,x,,: ............................................... pursua~ to application dated ...................... JJl~: ........... ~ ............. , 19.6J., and approved by the Building Inspector. Fe~ $...S..0..~ .......... Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z. ~ ..... Date ............. Sept... ~9 .... , 19.69. THIS CERTIFIES that the building located at ...Il/IL ]lol'th .La~ ....... Street Map NoGa~d. Ba~, .lts~lock No. 8~ .Ill .Lot No. l~..But .M~.$olt...I~,~Z, .... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... I~.. · ~0. ·., 1969. pursuant to which Building Permit No. dated ......... Ma~' .... ~0' · ', 19 69', was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . -P~l~t®. ~e. f~aily, dv®t.l.$ng ...................................... The certificate is issued to . Q~Ox'go .to. go~h ...... 0~* .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ~t,..t~ ,..1.969. · .b~. 1t, .~l,X~t... '"/~"*dBuilding I~ .......... 'BoUSe ~ 2~ [orth Lane SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WROM IT MAY CONCERN: at 7The' sewage d/~sposal facilities for a structure located (Give deed location) , ~ have been inspected by this department and found to be satisfactory. SEP 1 1 196~ District Engineer ~ ~'(~,," ' District Engineer New ork Boar ~ t~ BUREAU OF ELECTRICITY N757752 ~ JOhN street, N~w vor~,N~w YORk ~OO~a ~,,,,,. September 10, 1969 ¥..,..,~.. ~,,.,,,,3.,, 361072 N , c ~ { S ~.~ ~h~s ~e~i~es, Goerge L.Koch n/s NorthLane, off Old Orchard, East Marion, L.I. ~,, ,~,,..~,,/~,,,,.~,,~ ~,,,-,,,;,,,,: ,~,.~,.,,,,.,, x ~ ~, /.*/. ~ ~,,,~ ~t. Outs ide ~,.,.,~,,,, m,,.~- ~.,,, ,,. ......... ,,,,~,,,.,~,,,, September 9, 19~9 ~lxTuk~ ~ --- ] - ~JRTuR~s ] RANGE~ COO~,NGU~CK~ Oy~Nq ~DIS~h~U~R~i~UST FAN~ ~ ) ~" ) '2 6 i r i 1 7.5; , 2 Fr. ' ~ ~ ~ I ' I , : ' x ' i 1/O I 1 1/0 1 150 ~CB ~ j . Motor/s: 1-1/2hp Water Heater: 1-4.5KW Dettner Electric Co. STATE SUPERINTENDENT Box 482 Riverhead, b.I. ,,~,,. /~ ~ APPLICATIOn' FOR B'~/LDING Date ......... ~..C~., .~. ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or 'in ink and submitted in duplicate to the Building Inspeci~r. b. Plot plan showing location of lot andof buildings on premises, relationship to adjoining premises or public streets or areas,.and giving a detailed description of layout of property must be drawn'.on the diagram which is part~)f this apphcation. 'c. The work covered' by this application may not be commenced before issuance of Building Permit. dt Upon approval of this appliqati<m, the Building In spector will issue a Building Permit to the applicant. Such permit shall be kept .on the premises availab!!~ for inspection throughout the progress o~the work. · e. No building shall be_occupied or us~l in whole or~n part for any l~urpose whatever until a Certificate of Occupancy shall have beed granted by the Building Inspe~ller. APPLICAeI'I~)N~ IS I-i~_~I~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold~ Suffolk Oounty, New York, and other appUcable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with ~ll applicable laws, ordinances, building code, housing c0de, and regulatinns. ~ /..~...~. , , .................... .... , -(~ignature<of applicant, or name if a corpo at'o ) (Address of applicant) · State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plu~lb:er or builder ................ .~...k~....~..~..l'~-~. .................................................................. . Name of owner of premises ~__~ ~ ~:~ ~Z. ~ .~ ... ~.... /~_~ .~..~... If applicant is a corporate, signature of duly authorized officer. (Name .and title of corporate officer) 1. LoCatiOn of land on which propped work will be done. Map No....~...~.../~..~. .... Lot No...]..~../~..... Street and ~,,mber ~or~-~ {.A~I~: ~ ~:~ ~.~.. ..~'.~..~.~...qF ~ .l~.~.~.~?....~.:~.,. "' ~': '~ ~ ............................ Muni~i~ty 2. S~te exist~g use and ~cup~cy of premi~ ~ d intended ~e ~ ~cu~ of ~ ~ction. a. ~i~g use and ~cup~cy .......... ~ ~..Q ~.~.~.~ ) ~ .~ ..................................... b. Int~ded ~ ~d ~cup~cy ............ Q ........................................ 3. Nature of work (check which applicable): New Building ........ Addition ........ Alteration ........ Repair ..... '... Removal ........ Demolition . ....... Other Work (Describe) ...................... 4. Estimated Cost . ././~,...~.,. ........ ' ........... Fee (to be ~aid on filing this application) 5. If dwelling, number of dwelling units ] Number of dwelling units on each floor If garage, number of cars ................ ........................................................ 6. If business, commercial or mixed occupancy, spec ify nature and extent of each type of use .............. 7. Dimensions of existing structures, if any: Front ...." .......... Rear .... '-. ........ Depth ............. ight ~ He ................ Number of Stories ........................................................ Dimensions of same structure with alterations o~ additions: Front .... ~ ........ Rear ....-7 .......... Depth ......... ..--w .... Height .... ~ ......... N.umber of Stm'ies ........................~... 8. Dimensions of entire new construction: Front ...7-.~ .~ .o." ....... Rear --/. %:.-.?.~.... Depth "~ %~ · °'' · " Height .I..N..-. ?. .... Number of 8l~ries ......................................................... ................ .. 9. Size of lot: Front ~ ~ ~t Rear . ..'~.~ ....... Depth .......... 10. Date of Purchase ............................... Name. .of.,F~r~e~r Owner .......................... 11. Zone or use district in which premises are situated ..... ~.. ~ ................ ~ .................. 12~ Does proposed construction violate any zoning law, ~rdinanee or regulation? .... ~....~. .................. 13. Name of Owner,of premises .~.~; ?..~..~.~.~: .~..°.9. · -~ddress7.{k .~.~.~-c-~.~.~-. .~.T.:. Phone No.'~'~.'}.'..~.G. .~..~ Name of Architect ............................. .~ddress ~.~,'~1~ ~ Phone No .... 2' ...... Name of Contractor /~..~. ~.~...~..L/(.~9.~'P.% ....... Address .............. Pkone No/:.~.~ ...q.~..~.'l PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propose~ and indicate all set-back dimensions from property lines. Give street and block number or description acoording to deed, and show Street names and indicate whether interior or cromer lot. STATE OF AI~ ~0~ )S.S. COUNTY oF ~.~..) ...... ~..~..~./~'~_~.~ .... ~.~ .'~. ~ ~. ........... being du~Y swo~, dep~ ~d ~ys ~t he is ~e appli- (N~me of ~divid~l signing applicat~n) c~t a~ve n~ed. He is the ..................... ~ ~. ~ .~.~ ......................................... (~n~a~r, a~ ~ate ~i~r, etc.) of ~id own~ ~ owne~, ~d ~ duly au~zed ~ p~ or have pe~ ~e ~d ~k ~d ~ m~e ~d file th~ application; ~at ~ stammers ~n~m~ in ~is applica~n ~ ~e to ~e best of h~ ~owl~ge ~d belief; .and ~at ~he ~k will be p~ in ~e manner set fo~ in the application filed ~e~. Swo~ ~ bef~ me ~is .... ~.., day ~f ..~.,~~~ 19~. ~ ~O~~' N~ ~blic, .................... Y M~ ~f ..... ~t ....... ~':'" ) ............... ~~ ~TARy PUS/lC, State of New York No. 52-8125850. Suffolk County Term Expires March 30. ]9~ I r ~ r oC 0 gOI- o" Jl 4l JT Ii . FSAL~:oN,J y ILO' ~ E-- c o t,,4 D F Loo~,. p L/M,~ ~C akbD,:, l/4 % Ii.c:," REVISIONS ~,~T DATE DRAWING NO VAN ~UMM£RN AND WE'.IGOL~ ECT$ AND PLANNERS 40 GUERNSEY STREET 366 MADISON AVENUE CHKD ,,\ .. PLoT TOP' ~ ~.=;,t,J D FI.cz>P.. NO. I RE ISIONS 5EcUC~kJ ~ & PLOT PLA-~ DATE, / DATE SCALE JOB NO. VAN SUMMERN & WI~,IGOLD ARCHITECTS & PLANNER'S 366 MADISON AVENUE 40 GUERNSEY STREET NEW YORK, N. Y. 10017 STAMFORD~ CONN. 06901